Tip 1: Digital rectal examination is the main-stay of diagnosis for perineal hernia’s. Palpate both sides even if the external swelling is only obvious on one side. A tip for the digital rectal exam is to make your finger into the shape of a hook and point it laterally. As you withdraw your finger, if the finger slides right out then it is not a hernia; if it catches then it is a perineal hernia.
Tip 2: Anal sacculitis is most commonly seen in small-breed dogs but can present from a wide variety of signalments. Surgery to remove the anal sacs is indicated when there has been a failure of appropriate medical management (manual expression, lavage, instilling topical antibiotic-corticosteroid preparations +/- systemic antibiotics, adding fibre to the diet and treating concomitant dermatoses) or in cases of neoplasia.
Tip 3: When suturing the urethral mucosa in a perineal urethrostomy make sure you identify the edge of the urethral mucosa accurately. Sterile cotton buds are useful to blot the haemorrhage away to help identification of the mucosal edges (don’t use electrocautery). Take a bite of the urethral mucosa, a small bite of the tunica to help compress the intervening cavernous tissue, and then appose the mucosa to the skin.
Would you like to find out more? This August 24- 25th is the Perineal and Urogenital Surgery Workshop.. it’s a little bit smelly but the surgical techniques you walk away with are incredibly valuable! Click to register today! For more information see the brochure here.
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